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Management of Acute Coronary Syndromes in Older People: Comprehensive Review and Multidisciplinary Practice-Based Recommendations.
Narendren, Ahthavan; Whitehead, Natalie; Burrell, Louise M; Yudi, Matias B; Yeoh, Julian; Jones, Nicholas; Weinberg, Laurence; Miles, Lachlan F; Lim, Han S; Clark, David J; Al-Fiadh, Ali; Farouque, Omar; Koshy, Anoop N.
Afiliación
  • Narendren A; Department of Cardiology, Austin Health, Heidelberg, VIC 3084, Australia.
  • Whitehead N; Department of Cardiology, Northern Health, Epping, VIC 3076, Australia.
  • Burrell LM; Department of Cardiology, Austin Health, Heidelberg, VIC 3084, Australia.
  • Yudi MB; Department of Cardiology, Austin Health, Heidelberg, VIC 3084, Australia.
  • Yeoh J; Department of Medicine, The University of Melbourne, Melbourne, VIC 3052, Australia.
  • Jones N; Department of Cardiology, Austin Health, Heidelberg, VIC 3084, Australia.
  • Weinberg L; Department of Cardiology, Austin Health, Heidelberg, VIC 3084, Australia.
  • Miles LF; Department of Cardiology, Austin Health, Heidelberg, VIC 3084, Australia.
  • Lim HS; Department of Medicine, The University of Melbourne, Melbourne, VIC 3052, Australia.
  • Clark DJ; Department of Critical Care, The University of Melbourne, Melbourne, VIC 3010, Australia.
  • Al-Fiadh A; Department of Anaesthesia, Austin Health, Heidelberg, VIC 3084, Australia.
  • Farouque O; Department of Critical Care, The University of Melbourne, Melbourne, VIC 3010, Australia.
  • Koshy AN; Department of Anaesthesia, Austin Health, Heidelberg, VIC 3084, Australia.
J Clin Med ; 13(15)2024 Jul 28.
Article en En | MEDLINE | ID: mdl-39124683
ABSTRACT
Managing health care for older adults aged 75 years and older can pose unique challenges stemming from age-related physiological differences and comorbidities, along with elevated risk of delirium, frailty, disability, and polypharmacy. This review is aimed at providing a comprehensive analysis of the management of acute coronary syndromes (ACS) in older patients, a demographic substantially underrepresented in major clinical trials. Because older patients often exhibit atypical ACS symptoms, a nuanced diagnostic and risk stratification approach is necessary. We aim to address diagnostic challenges for older populations and highlight the diminished sensitivity of traditional symptoms with age, and the importance of biomarkers and imaging techniques tailored for older patients. Additionally, we review the efficacy and safety of pharmacological agents for ACS management in older people, emphasizing the need for a personalized and shared decision-making approach to treatment. This review also explores revascularization strategies, considering the implications of invasive procedures in older people, and weighing the potential benefits against the heightened procedural risks, particularly with surgical revascularization techniques. We explore the perioperative management of older patients experiencing myocardial infarction in the setting of noncardiac surgeries, including preoperative risk stratification and postoperative care considerations. Furthermore, we highlight the critical role of a multidisciplinary approach involving cardiologists, geriatricians, general and internal medicine physicians, primary care physicians, and allied health, to ensure a holistic care pathway in this patient cohort.
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Texto completo: 1 Banco de datos: MEDLINE Idioma: En Revista: J Clin Med Año: 2024 Tipo del documento: Article País de afiliación: Australia

Texto completo: 1 Banco de datos: MEDLINE Idioma: En Revista: J Clin Med Año: 2024 Tipo del documento: Article País de afiliación: Australia